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Introduction: In this randomized prospective study, 2% - diltiazem topical gel and 0.03% -GTN ointment were compared in patients with chronic anal fissure. Methods: This semi-experimental study consisted of sixty six outpatients (34 females and 32 males) with chronic anal fissure, who referred to the gastroenterology clinic. Patients were randomly classified into two groups. Group A received GTN ointment (0.03%), whereas group B was treated with Diltiazem gel (2%). The treatment was administered twice daily for 8 weeks. Healing and side-effects were recorded to be compared after 8 weeks. Results: In group A, the anal fissure was thoroughly healed within 53.3% of patients, moderately healed for 6.7% of patients and not healed in 25.8% of patients. Moreover, side-effects were noted in 15(46.9%) patients (P= 0.482). Two (6.2%) patients had intolerable headache and discontinued the study, 11 (34.3%) patients suffered from headache and 2 patients (6.2%) were reported to have orthostatic hypotension. In group B, healing occurred in 21(67.7%) out of 31 patients and 1 (3.2%) case of headache was noted(P= 0.0001). Conclusion: The present study has demonstrated that topical diltiazem can be preferable to GTN owing to the absence of side-effects.

Keywords: Anal Fissure, Glyceryl Trinitrate, Topical Diltiazem

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